CT-based fractional flow reserve: development and expanded application


  • Ryo Torii Department of Mechanical Engineering, University College London, London, UK
  • Magdi H Yacoub Department of Surgery and Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Aswan, Egypt and Magdi Yacoub Institute, Harefield Heart Science Centre, Harefield, UK and National Heart and Lung Institute, Imperial College London, UK




Computations of fractional flow reserve, based on CT coronary angiography and computational fluid dynamics (CT-based FFR) to assess the severity of coronary artery stenosis, was introduced around a decade ago and is now one of the most successful applications of computational fluid dynamic modelling in clinical practice. Although the mathematical modelling framework behind this approach and the clinical operational model vary, its clinical efficacy has been demonstrated well in general. In this review, technical elements behind CT-based FFR computation are summarised with some key assumptions and challenges. Examples of these challenges include the complexity of the model (such as blood viscosity and vessel wall compliance modelling), whose impact has been debated in the research. Efforts made to address the practical challenge of processing time are also reviewed. Then, further application areas – myocardial bridge, renal stenosis and lower limb stenosis – are discussed along with specific challenges expected in these areas.






Review articles